How to Follow the Mediterranean Diet

The health benefits

The typical Western diet is high in animal fats and preservatives, but low in fruit and vegetables. Decades of high quality scientific research have shown this food combination is partially responsible for triggering many chronic diseases and cancers currently prevalent in the UK and other industrialised nations.

Research has also shown that following a Mediterranean Diet can drastically reduce the chance of developing conditions such as heart disease, Type 2 diabetes, high blood pressure, obesity and even Alzheimer’s disease. (See separate leaflet called 'Health Benefits of a Mediterranean Diet' and Note 1.)

So, switching from a Western to a Mediterranean Diet represents a healthy lifestyle choice. It can reduce the risk of a premature death and increase the chance of a healthy retirement, free from long-term medication. And, unlike long-term medication, the Mediterranean Diet has no known damaging side effects.

The Mediterranean Diet

General principles

The Mediterranean Diet is not about quick fix 'superfoods', beloved of food writers. Nor is it a strict list of prohibitions preventing occasional excess. Rather, the Mediterranean Diet is a formula for healthy day-to-day eating over the long term. Here's a quick guide for those who'd like to dip their toes in the warm, blue waters of a Mediterranean Diet:

• Maximize your intake of vegetables, legumes, fruits and whole grain cereals.
• Limit your red meat intake - fish and poultry are healthy substitutes.
• Where possible, use mono-unsaturated olive oil or rapeseed oil in place of animal fat such as butter or lard.
• Limit your intake of highly processed 'fast foods' and 'ready meals', where you cannot tell saturated fat and salt intake.
• Eat no more than moderate amounts of dairy products, and preferably low fat ones.
• Do not add salt to your food at the table - there is already plenty there.
• Snack on fruit, dried fruit and unsalted nuts rather than cakes, crisps and biscuits.
• Drink (red) wine during meals, but no more than three small glasses per day if you are a man and no more than two small glasses per day if you are a woman.
• Water is the best "non alcoholic beverage" (as opposed to sugary drinks). Although health benefits have also been claimed for various teas and coffee (see Note 3).

Mediterranean Diet ingredients

Now, let's consider what sorts of food we need to eat to follow a Mediterranean Diet. The World Health Organisation (and the UK Government Change4Life campaign) recommend we eat five portions of fruit and vegetables a day. This guidance is partly based on, and entirely consistent with, research into components of the Mediterranean Diet (see Note 4).

Health-promoting food types to be encouraged

The following contain essential nutrients and have health promoting properties.

Beneficial food types, to be carefully measured

The following Mediterranean Diet components contain essential nutrients and have health promoting properties. However, there are known health risks if consumed in excess.

Restricted foods

The following foods contain essential nutrients, but also carry significant health risks if consumed in excess.

A note on weight reduction

Research shows that people who adopt a strict Mediterranean Diet (such as the one described below), and take regular exercise, often find this helps keep their weight under control. Mediterranean style meals, packed with fruit, veg and grains can be quite filling, reducing any desire to top up with extra calories.

If this doesn't do the trick, then you may need to reduce your energy intake and/or increase your physical activity. The recommended way to find out whether you need to lose weight is to measure your Body Mass Index (BMI) (See separate leaflet on 'Obesity and Overweight'). If you'd like to take control of weight loss and still follow a varied Mediterranean Diet, then you can do this by:

Reducing energy intake

In the notes above, we've given an indication of the high energy foods. If you go wild with oil, nuts with the nuts, or take too much alcohol or sugary drink, your body may take in more energy than it needs and store it as fat. If excess weight remains a problem, then it is worth seeing if you can reduce calorie intake levels.

Increasing exercise

It is recommended that, where possible, adults undertake (at least 30 mins) daily exercise, which can be as straight forward as taking long walks, jogging, cycling or swimming, so as to sustain a minimal level of fitness. This also helps the body regulate weight. Body regulatory mechanisms tend to get a bit sluggish if left sitting around for too long. Any extra exercise will help burn excess calories and fat.

See separate leaflet on 'Weight Reduction - How to lose weight'.

Reducing other health risk factors

Sticking to a Mediterranean Diet and keeping active goes a long way to keep you healthy and to reduce your risk of various serious diseases. But remember, it is part of a 'package' of things that you can do to keep healthy. The other main things that you can do are to not smoke, and have your blood pressure checked every 3-5 years (unless advised more often by a doctor or nurse). Oh, and if you are fortunate enough to go to the 'Med' to try the diet in its natural surroundings - remember to keep out of the sun as much as possible!

Adopting a strict Mediterranean Diet

Scientific research has shown that the closer individuals can get to the 'ideal' Mediterranean Diet, outlined in the pyramid chart below, the greater the health advantage - in that, the benefit of adopting the whole dietary pattern exceeds the summated health-giving properties of its individual components.

• Vegetables: a cup of raw leafy vegetables or half a cup of other vegetables.
• Potatoes: 100g.
• Legumes: one cup (100g) of cooked dry beans.
• Nuts: 30g. Eat as a snack or sprinkle on food for added taste.
• Fruit: one apple, banana, one orange, 200g of melon or watermelon, 30g of grapes.
• Meat: 60g of cooked lean meat or fish.
• Grains: half a cup (50-60g) of cooked pasta or rice; one slice of bread (25g).
• Dairy:one cup of milk or yoghurt; 30g of cheese.
• Eggs: 1 egg.
• Wine: 125ml glass of average strength red wine.

In summary

The strict Mediterranean Diet has been assessed and found to contain all the essential nutrients required for normal health. But, more than this, it also prevents excesses of ingredients linked to ill-health.

Notes

1: In the mid-1900s, it was discovered that certain peoples of the Eastern Mediterranean (particularly Greece and southern Italy) lived longer, disease free lives than peoples in industrialised Western countries, including the UK, even though those in the West had easy access to sophisticated health services. A key reason turned out to be differences in diet. This led researchers to analyse and successfully test an ideal ‘Mediterranean Diet’ on Westerners.

2. From a historical perspective, many aspects of the traditional Mediterranean Diet, discussed here, were first introduced into Britain back in Roman times, when locals also ate a lot of 'Celtic beans'. Of course, this was before Western civilisation entered its Dark Ages. So, perhaps the Mediterranean Diet should be listed as one of the things ‘the Romans did for us’?

3. It is recommended that we drink at least 6-8 glasses of non-alcoholic fluid through the day, to prevent dehydration in the temperate UK climate. More would be required in hotter weather.

4. Legumes, eg beans, feature in the Mediterranean Diet and count as one of the WHO daily fruit and vegetable portions.

5. Traditional Mediterranean folks of old considered butter to be only fit for barbarians. Toast drizzled with a little olive olive oil, herbs and garlic is still a popular Mediterranean snack.

6. Sunflower oil is often used for cooking in the UK. It is a 'polyunsaturated fat' that is healthier than saturated animal fats.

Try it for yourself

If you'd like to try the full Mediterranean Diet at home, we've translated the pyramid into this handy tick-chart of food to be consumed through the week (as used by the author).